Should You Make Your Own Facemask?

Is a homemade mask a useful complement to other COVID-19 preventive measures, or an ineffective measure that offers false hope?

Note from the writer: This article was updated April 5 to include an important new analysis of the ineffectiveness of various types of cloth and homemade masks in reducing the spread of disease. The article now presents evidence that masks can be helpful, then a new analysis indicating they may not work anywhere near as well as we hope, and then, finally, how to make one. This article is not intended to offer advice on whether everyone should don a mask, a question over which expert views continue to see-saw as the science develops.

Asof this original writing on March 31, only people with COVID-19 symptoms or those caring for them were advised to wear facemasks by the World Health Organization (WHO), the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Surgeon General. But if facemasks work for the sick and the caring, why shouldn’t everyone wear one to help reduce the spread of coronavirus?

Good question. Since then, the CDC came around to answering it, urging all Americans to wear a mask when outside their homes.

In parts of Asia, health officials had already been encouraging masks for all. The Czech Republic made nose and mouth coverings mandatory for people who are out in public, according to an article by Kelly Servick in Science, a publication of the American Association for the Advancement of Science.

“The big mistake in the U.S. and Europe, in my opinion, is that people aren’t wearing masks,” said George Gao, head of the Chinese Center for Disease Control and Prevention.

“This virus does have the ability to transmit far easier than flu,” CDC director Dr. Robert Redfield told Atlanta radio station WABE prior to the new recommendation. “It’s probably now about three times as infectious as flu.”

Arguments for and against: A brief overiew

Reasons to advise against the widespread use of facemasks include the fact that healthcare professionals need them badly. Some 200 workers at one New York hospital have become sick, and two nurses have died in city hospitals, all amid a lack of protective gear. Hospitals around the U.S. are asking for donations of masks and other protective gear.

Also, people in general may not use masks properly, and it remains unclear how far droplets infected with COVID-19 travel through the air, and so it’s unclear how effective masks would be if people are already keeping 6 feet apart. Some experts also argue that a mask might give people a false sense of security and cause them to become lax on other preventive measures.

The argument for a mask is simple: A good one, used properly, can help prevent infected respiratory droplets from a person who has COVID-19 from becoming airborne and either landing on someone else or on a shopping-cart handle. This is a vitally important point with this disease, since it’s known that a large number of people are carrying and spreading the disease with few or even no symptoms.

To a lesser extent, a mask can help keep such droplets away from the nose and mouth of an uninfected person, but that’s true only if the mask is of sufficient quality, good fit, and if it’s used properly.

“Of course masks work — maybe not perfectly and not all to the same degree, but they provide some protection,” writes Zeynep Tufekci, a professor of information science, in a New York Times opinion piece. “World Health Organization officials wear masks during their news briefings,” she points out.

Evidence that masks work - Regularly experiment with face mask testing equipment for mask testing

Importantly, facemasks should not be relied on by anyone in lieu of other preventive measures, including proper handwashing, home sanitizing, staying away from places where people gather or frequent, and physical distancing when you must go out — health experts agree on all that.

But facemasks can be a useful complement, research has shown, helping slow the spread of a viral respiratory disease like COVID-19 (based, though, on studies of the flu virus).

A study back in 2010 of the H1N1 influenza pandemic, reported in the Journal of Infectious Diseases, suggested hand-washing and facemasks together “may reduce respiratory illnesses in shared living settings.” Another study, from 2012 in the journal BMC Infectious Diseases, suggested “household transmission of influenza can be reduced by the use of NPI [non-pharmaceutical interventions], such as facemasks and intensified hand hygiene, when implemented early and used diligently.”

“It would be reasonable to suggest vulnerable individuals avoid crowded areas and use surgical face masks rationally when exposed to high-risk areas,” researchers wrote March 20 in the Lancet Respiratory Medicine journal. “As evidence suggests COVID-19 could be transmitted before symptom onset, community transmission might be reduced if everyone, including people who have been infected but are asymptomatic and contagious, wear face masks.”

“The value of the mask isn’t necessarily to protect you from getting sick, although it may offer some protection,” former FDA Commissioner Scott Gottlieb told CBS News. “It’s to protect you from other people. So when someone who’s infected is wearing a mask, they’re much less likely to transmit infection.”

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